Department of Applied Economics, Collegium of Finance and Management, Warsaw School of Economics SGH, Warsaw, Poland.
PLoS One. 2021 Aug 17;16(8):e0256267. doi: 10.1371/journal.pone.0256267. eCollection 2021.
Local hospitals play a crucial role in the healthcare system. In this study, the efficiency of Polish county hospitals is assessed by considering characteristics of hospitals that may determine their performance, such as the form of ownership, size, and staff structure. The main goal was to analyze the effect of three possible determinants on efficiency: ownership, the presence of an Emergency Department, and the presence of an Intensive Care Unit. The study covered different subgroups of hospitals and different approaches of inputs and outputs. An input-oriented radial super-efficiency DEA model under variable returns to scale was used for the efficiency analysis, and then differences between distributions of efficient and inefficient units were evaluated using a Chi-square test. A Kruskal-Wallis test was also used to analyze differences in mean efficiency. Inefficiency scores were regressed with hospital characteristics to test for other determinants. These results did not confirm differences in efficiency concerning ownership. However, in some subgroups of hospitals, running an Emergency Department or an Intensive Care Unit had a significant effect. Tobit regression results provided additional insight into how an Emergency Department or Intensive Care Unit can affect efficiency. Both cases had an effect of increasing inefficiency, and the data suggested that the department/unit size plays an important role.
当地医院在医疗体系中发挥着至关重要的作用。本研究通过考虑可能决定医院绩效的特征（如所有权形式、规模和人员结构）来评估波兰县医院的效率。主要目标是分析三个可能的决定因素（所有权、急诊部和重症监护室）对效率的影响。该研究涵盖了不同类型的医院和不同的投入和产出方法。采用可变规模收益的输入导向径向超效率 DEA 模型进行效率分析，然后使用卡方检验评估有效和无效单位分布之间的差异。还使用克鲁斯卡尔-沃利斯检验分析平均效率的差异。使用医院特征回归分析无效分数，以检验其他决定因素。这些结果并未证实所有权方面的效率差异。然而，在一些医院亚组中，运行急诊部或重症监护室具有显著影响。Tobit 回归结果提供了有关急诊部或重症监护室如何影响效率的更多见解。这两种情况都增加了效率低下的影响，数据表明部门/单位规模起着重要作用。
